Ball valve syndrome

PURPOSE: We aimed to assess whether maternal sleep disorders (SD) diagnosed before or during pregnancy is associated with increased risk of long-term neurodevelopmental disorders (LNDD) in children. METHODS: In this retrospective, population-based cohort study, we included all live births in South Korea between Jan 1, 2008, and Dec 31, 2012. Maternal SD exposure was defined by 10th revision of the International Classification of Diseases (ICD-10) codes G47* or F51* and G25.8, and timing was categorized as pre-last menstrual period (LMP) or pregnancy onset, with the former identified during a one-year lookback period prior to the estimated LMP. The primary outcome was LNDD (ICD-10 F70-F95) ascertained up to Dec 31, 2023. We performed 1:5 propensity-score matching and used Cox proportional hazards models to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). RESULTS: Of 1,993,494 births, 33,229 children (1.7%) were born to mothers with SD. The matched cohort comprised 33,183 SD-exposed and 160,131 unexposed children. In the matched analysis, SD exposure was associated with higher risk of any LNDD (HR 1.36, 95% CI 1.32-1.41; P < 0.001). Both pre-LMP SD (HR 1.31, 1.26-1.35) and pregnancy-onset SD (HR 1.18, 1.12-1.25) were significantly associated with LNDD risk. Subtype analyses identified significant risks for insomnia (HR 1.28, 1.23-1.33), restless legs syndrome (HR 1.48, 1.18-1.86), and sleep apnea (HR 1.32, 1.01-1.73). CONCLUSION: Maternal SD before or during pregnancy is independently associated with increased LNDD risk in offspring. CURRENT KNOWLEDGE/STUDY RATIONALE: Maternal sleep disorders (SD) are highly prevalent during pregnancy and have been linked to adverse obstetric outcomes, yet their long-term impact on offspring neurodevelopment remains poorly characterized. We leveraged a nationwide cohort of nearly 2 million births with up to 15 years of follow-up to address existing research gaps regarding the timing of SD onset and the specific influence of various SD subtypes-including insomnia, restless legs syndrome and sleep apnea-on child brain health. STUDY IMPACT: This study provides robust evidence that maternal SD, particularly before or during pregnancy, is independently associated with a significantly increased risk of long-term neurodevelopmental disorders in children. These findings highlight the critical need for early identification and management of sleep disturbances in women of childbearing age to potentially mitigate neurodevelopmental risks in the next generation.